Patient Centered Primary Care Program

PW_E184990

Empire is excited to announce the launch of the Enhanced Personal Health Care Program (the Program). This Program empowers primary care physicians (PCPs) to engage in those comprehensive primary care functions that move us toward a coordinated, evidence-based care model that has the greatest impact on achieving the triple aim of improved quality, patient experience and affordability.

The Program includes our own Empire-specific Enhanced Personal Health Care Program as well as the Comprehensive Primary Care (CPC) initiative (collectively, the Program). CPC is an effort by the Centers for Medicare and Medicaid Services (CMS) to align multiple payers around select physician practices in specific geographic areas for the purpose of transforming payment and practice redesign.

We believe the doctor-patient relationship is the most important in health care. Every patient should have a relationship with a primary care physician who knows and understands their individual health care needs, can provide comprehensive “whole patient” health care services, and will serve as their champion, helping them navigate the complex health care system to ensure they get the care they need when and where they need it. This is the key to improving quality and outcomes and, subsequently, lowering costs.

Our Program is based on a simple principle – that primary care physicians and their practice team, provided with the right tools, information, and resources, are best equipped to optimize the health of their patients and improve the affordability of health care. This Program will:

Make a significant investment in primary care that allows primary care physicians and their practice team to do what they can do best: manage all aspects of their patients’ care.

Provide primary care physicians with tools, resources and meaningful information that promote (1) access, (2) shared decision making, (3) proactive health management, (4) coordinated care delivery, (5) adherence to evidence based guidelines and (6) care planning built around the needs of the individual patient, leading to improved quality and affordability for our customers and their patients.

Help redesign the current payment model to move from volume based to value based payment, aligning financial incentives and providing financial support for activities and resources that focus on care coordination, individual patient care planning, patient outreach and quality improvement.

Improve the patient experience by:

creating better access to a primary care physician who will not only care for their “whole person” but will become their health care champion and help them navigate through the complex health care system,

making them active participants in their health care through shared decision making, and

For a comprehensive description of the quality and utilization measures and how they are scored, access an example of the Measurement Period Handbook. If your organization participates in the Program, a copy of the Measurement Period Handbook that is specific to your Measurement Period will be distributed to your practice approximately 90 days prior to the start of the Measurement Period.

Program Topics

To learn more about specific Program topics, access these links below:

Footer Links:

Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc., licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans, serving residents and businesses in the 28 eastern and southeastern counties of New York State. All external sites will open in a new browser window. Please view our Website Privacy Policy for more information.